First Edition: November 1, 2011

Today's headlines include a report that the health law's early retirees' health insurance fund may be running out.     

Kaiser Health News: Insuring Your Health: $6.9 Billion Spent Yearly On 12 Unnecessary Tests And Treatments
In her latest Kaiser Health News consumer column, Michelle Andrews writes: "For many adults, a routine visit to a primary care physician might involve blood tests, a urinalysis, an electrocardiogram, maybe a bone density scan. Too often, however, these tests are inappropriate and they cost a bundle, according to a recent study,  not only for the health care system but also for individuals, who are increasingly footing more of the bill for their care" (Andrews, 10/31).

Kaiser Health News: Capsules: Health Expert Urges States To Slow The Move To Medicaid Managed Care
Now on the Kaiser Health News’ blog, Mary Agnes Carey reports: "As more states turn to managed care to reduce Medicaid costs, Judy Feder is urging caution. Feder, a  professor at and former dean of the Georgetown University's Public Policy Institute , is worried that officials’ enthusiasm for managed care in Medicaid "might get out of hand," and she is urging them to move slowly when it comes to caring for the nearly 9 million "dual eligibles,"  Medicaid enrollees who also qualify for Medicare” (10/31). Check out what else is on the blog.

Politico: Social Forces May Limit Health Care Reform
The health care reform law gives federal health officials a new mandate to address the fact that racial and ethnic minorities tend to be sicker than the rest of the population. But there are limits to what they can actually do about the problem. The root causes, public health experts say, are social forces such as poverty, poor schools and crumbling infrastructure that are outside the control of the Department of Health and Human Services (Feder, 10/31).

The Wall Street Journal: Fund To Pay For Early Retirees' Health Insurance Running Out
A $5 billion fund created as part of the health-care overhaul to pay for health insurance for early retirees will run out of money by September 2012, according to a federal report released Monday. Around 6,000 employers are currently getting subsidies through the program to help pay for benefits for retired workers between the ages of 55 and 64. The fund reimburses 80% of the eligible claims for between $15,000 and $90,000 paid on behalf of a retiree who isn't yet eligible for Medicare, the federal insurance program for people age 65 and older (Radnofsky, 10/31).

Politico: Social Security Appears On Deficit Panel Agenda
If the committee were to take up changes to Social Security, it could show that Congress is looking for systemic changes to the nation's finances — something markets and credit rating agencies want to see. It may not help the committee get to $1.2 trillion, but Democrats are all but certain to insist that Boehner commit to serious changes on taxes alongside such entitlement restructuring. One Social Security change being floated is a change to the consumer price index, which has been considered in the course of other spending debates over the past year (Sherman and Raju, 10/31).

USA Today: Medicare Report: Improve Tracking Of Serious Hospital Errors
Medicare inspectors must do a better job of tracking reports of serious mistakes in care at the nation's hospitals, as well as of informing rating agencies of the errors, according to a report released Tuesday by the agency's inspector general (Kennedy, 11/1).

The New York Times: Congress Questions The I.R.S. About Delays In Its Oversight Of Nonprofit Hospitals
In August, the Illinois Department of Revenue moved to revoke the property tax exemptions enjoyed by three major nonprofit hospitals after a court ruling determined that a fourth hospital in the state did not provide enough charity care to justify the tax benefit. Those hospitals, however, remain exempt from federal taxes — a far bigger benefit — because the Internal Revenue Service is not collecting information to assess the extent of the care for poor and uninsured patients that nonprofit hospitals nationwide are supposed to provide (Strom, 10/31).

Los Angeles Times: Obama Tackles Drug Shortages
President Obama is pushing federal regulators to do more to address dangerous shortages of crucial medicines, sidestepping a deadlocked Congress that has not dealt with the problem. In an executive order signed Monday, the president directed the Food and Drug Administration to press drug companies to more quickly report shortages to federal regulators, an early warning that advocates say can help mitigate shortages (Levey, 10/31).

The New York Times: City To Pay $70 Million In Medicaid Suit
New York City will pay the federal government $70 million to settle a lawsuit that accused the city of overbilling Medicaid by improperly approving home care for frail and elderly clients, both parties said on Monday (Hartocollis, 10/31).

The Wall Street Journal: $70 Million Medicaid Settlement
New York City agreed to pay $70 million to settle a Justice Department lawsuit that accused the city's personal-care services program of overbilling Medicaid for millions of dollars in reimbursements (Fitzgerald, 11/1).

The New York Times: A Nursing Home Shrinks Until It Feels Like A Home
Following in her mother's footsteps, Ms. Davis is now director of Green Hill Retirement Community, a nursing home and assisted living facility, and she is determined to make it into a place where residents feel little reason to leave. She has added fish tanks and bird cages, hung pictures on the walls carpeted the corridors, and brought in dogs for pet therapy. Still, the nursing home looks like... a nursing home. "No matter what you do, you can't get that homelike feeling in an institution because it's too big," she said (Tarkan, 10/31).

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